Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09790 | Date 21/08/2025 |
| Token No | SM/25-26/6685 21/08/2025 | Serial | 051 |
| Patient Name | Mrs. PURNIMA SINGH | Contact No | 9330506818 |
| Address | 25A/24 F D ROAD MALLICKPARA SERAMPORE 712203 | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||